Fireworks-Related Injuries -- Washington

To make certain fireworks legally available outside American Indian reservations, in 1982 Washington State changed its law governing the sale of fireworks during the July 4 holiday period (1). Previously, only non-explosive ground display devices were so available, while explosive ground display devices, aerial devices, and exploding firecrackers containing less than 50 mg of gunpowder were available only on American Indian reservations. In 1982, all three types, except sky rockets and missile rockets, were made available throughout the state. To determine whether the change in law was accompanied by a change in fireworks-related injuries, 15 hospitals in nine counties were contacted for the number of fireworks-related visits to emergency rooms between June 28 and July 6, 1982, the dates for legal sale of fireworks. For comparison, the number of fireworks-related visits during the same interval in 1981 was obtained from the same emergency rooms. Injuries were divided into five types: eye injuries, burns, lacerations, amputations, and other injuries. In addition, one large wholesaler of fireworks was asked to estimate the effect of the law change on sales.

Fourteen of the 15 hospitals contacted responded, and 11 provided the total number of fireworks-related visits for both years. Ten of these provided a breakdown into the five categories. All but one hospital reported an increase in 1982; this hospital reported no fireworks-related visits in either year. The total number of visits increased significantly from 39 in 1981 to 88 in 1982 (p 0.001). Burns, which increased from 17 to 46 (p 0.001), accounted for most of the difference. The number of eye injuries and lacerations also increased, but not significantly, from 10 to 15, and from three to eight, respectively. No amputations were reported in either year. Other fireworks-related visits increased from one to five.

The wholesale company, which is estimated to have sold half the fireworks in the state that did not go to American Indian reservations, had 2.5-fold greater July 4 holiday sales in 1982 than in 1981 (including 160 million exploding firecrackers in 1982 vs. none in 1981). The wholesaler did not know what effect the law change had had on sales on reservations. Reported by JM Kobayashi, MD, State Epidemiologist, Washington State Dept of Social and Health Svcs; Field Svcs Div, Epidemiology Program Office, Special Studies Br, Chronic Diseases Div, Environmental Health Svcs Div, Center for Environmental Health, CDC.

Editorial Note

Editorial Note: The above data strongly suggest that the 1982 change in Washington's fireworks law was associated with a significant rise in the number of fireworks-related injuries during the July 4 holiday period, probably because of the increased availability and use of firecrackers and aerial devices.

Although no precise statistical data exist on the total number of people injured by fireworks each year in the United States, the U.S. Consumer Product Safety Commission (CPSC) estimates that 11,400 such injured persons were treated in hospital emergency rooms in 1981; an estimated 8.8% of these were subsequently hospitalized as a result of their injuries. About 45% of all fireworks-related injuries seen in hospital emergency rooms in 1981 occurred among children 14 years of age and under (2). Approximately 60% of the injuries were burns, and 25% were contusions, abrasions, and lacerations (3).

Eye injuries account for some of the most disabling fireworks-related injuries. The Washington study did not measure the sequelae of injuries, but in a 5-year study in Arkansas, 30% of fireworks-related eye injuries resulted in permanent visual loss or enucleation (4). The lack of significant increase in the number of eye injuries after Washington's law changed may be explained by the non-legalization of rockets. In the Arkansas study, most fireworks-related injuries were caused by rockets.

Federal legislators have attempted to reduce the injury-producing potential of fireworks. Since 1966, the sale to consumers of large, Class B firecrackers, such as "cherry-bombs" and "M-80s," has been banned by federal law because of the large amount of explosive they contain. In 1976, CPSC lowered the permissible explosive charge in firecrackers to no more than 50 mg (0.772 grains) of powder and mandated performance, construction, and labeling specifications for all fireworks intended for public sale (collectively designated as Class C fireworks) (5).

CPSC and the American Pyrotechnics Association have maintained that banning Class C fireworks would stimulate the illegal manufacture and distribution of dangerous Class B fireworks and that the availability of safer, legal fireworks is the best control over illegal items (6).

The sale of Class C fireworks is regulated by the states. From 1977 to February 1982, the number of states that allowed the sale of all Class C fireworks increased from seven to eight. The number of states (including the District of Columbia) that allowed the sale of Class C fireworks as approved by the state enforcement authority or as specified by state law increased from 13 to 16. As of February 1982, an additional 11 states allowed the sale of sparklers and "snakes" only (7,8).

The trend in fireworks-related injuries has been generally upward since 1975, a year in which approximately 4,700 persons were treated for such injuries in hospital emergency rooms. The 1981 injury estimate of 11,400 equals that of 1976, the nation's bicentennial year and the previous peak year noted for such injuries since 1974 (3).

References

1. Harris J, Kobayashi J, Frost F. Injuries from fireworks. JAMA 1983;249:2460.

2. U.S. Consumer Product Safety Commission. Product summary report and NEISS (National Electronic Injury Surveillance System) estimates of national injury incidents. Washington, D.C.: U.S. Consumer Product Safety Commission, June 3, 1982.

3. Kale D, Harwood B. Fireworks injuries, 1981. Washington, D.C.: U.S. Consumer Product Safety Commission, undated.

4. Wilson RS. Ocular fireworks injuries and blindness. An analysis of 154 cases and a three-state survey comparing the effectiveness of Model Law regulation. Ophthalmology 1982;89:291-7.

5. Kale D, Harwood B. Fireworks injuries, 1979-1980. Washington, D.C.: U.S. Consumer Product Safety Commission, 1980.

6. U.S. Consumer Product Safety Commission, American Pyrotechnics Association. Fireworks in America. Washington, D.C.: U.S. Consumer Product Safety Commission, American Pyrotechnics Association, May 28, 1982.

7. U.S. Consumer Product Safety Commission. Product safety fact sheet No. 12: Fireworks. Washington, D.C.: U.S. Consumer Product

8. U.S. Consumer Product Safety Commission, American Pyrotechnics Association. Fireworks in America. Washington, D.C.: U.S. Consumer Product Safety Commission, American Pyrotechnics Association, May 28, 1982.

9. U.S. Consumer Product Safety Commission. Product safety fact sheet No. 12: Fireworks. Washington, D.C.: U.S. Consumer Product Safety Commission, Revised June 1980.

10. U.S. Consumer Product Safety Commission. Fireworks control laws (as of 2/1/82). Washington, D.C.: U.S. Consumer Product Safety Commission, undated.

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